Testimony: Repealing MaineCare Expansion


Testimony in Support of LD 902: “An Act to Repeal So-called MaineCare Expansion”

Senator Baldacci, Representative Meyer, and the distinguished members of the Committee on Health and Human Services, my name is Nick Murray and I serve as director of policy for Maine Policy Institute. We are a free market think tank, a nonpartisan, non-profit organization that advocates for individual liberty and economic freedom in Maine. Thank you for the opportunity to testify in support of LD 902.

MaineCare is a healthcare program designed for the most vulnerable, not for those who are able to work and without dependents. These adults should be participating in the labor force, and participating in the private market for health insurance. This is necessary not only for those individuals to become self-sufficient, but to ensure the responsible stewardship of tax dollars.

In just the first two years after voters approved expansion, MaineCare spending increased by more than 11.7%. In September 2020, a representative from the Maine Office of Fiscal and Program Review (OFPR) confirmed to the Legislature’s Joint Committee on Appropriations and Financial Affairs that Medicaid expansion had been the largest cost driver within Medicaid over FY20, rising by $280.1 million, or 9.1%, from FY19 to FY20. Approximately $250 million of that increase—or 88.3%—came from Medicaid expansion. 

If the pre-pandemic numbers were not alarming, Mainecare spending has grown 19% since 2018, adjusted for inflation. Rolls have grown 146% since January 2020, including adding more than 57,000 childless, able-bodied adults to the program. Of the more than 106,500 total enrollees, this population made 90% of the pandemic-era growth. Today, Maine spends nearly 34% of its budget on Mainecare, which in part pays for health care services for nearly 93,000 able-bodied, childless adults who have the wherewithal to support themselves.

A Kaiser Family Foundation study from 2009 showed a direct relationship between unemployment and Medicaid case rates, finding that with every 1% increase in the unemployment rate, the Medicaid caseload rises three-quarters of a percent. There is no substitute for a healthy economy, and while Maine should provide a safety net for those who truly cannot support themselves, providing benefits to able-bodied adults without children (especially those under 50) has a significantly detrimental effect on labor force adaptability. 

For these reasons, the state should repeal Medicaid expansion. Please deem LD 902 “Ought To Pass” to prioritize finite state resources for Medicaid for the truly needy, and look out for the welfare of individuals who can support themselves by crafting a program which incentivizes work and independence. Thank you for your time and consideration.